Quality Assurance Supervisor

JOB SUMMARY:

Manages individual audits and closed file reviews from beginning to end including audit, project planning, performance and reporting.  Reviews and analyzes operational data to identify areas of needed improvement. Manages, organizes, and leads the Quality Assurance process.  Measures performance opportunities through use of file reviews, calibrations and internal audit processes.  Provides business units value-added advice regarding risk identification and mitigation.  Understands the key strategic initiatives of the Company. Ensures action plans are developed and executed by appropriate accountable parties to improve/enhance processes and controls. Performance results and improvement opportunities are regularly communicated to various levels of leadership. Provides guidance and direction to quality assurance personnel. Facilitates and supports Recovery objectives and excellence in subrogation claims performance.

RELATIONSHIP: Reports to the Director of Operations.

DIRECT REPORTS: Directly manages claims quality assurance specialists and data miners.

JOB RESPONSIBILITIES:

Understands the strategic plan and key initiatives of the assigned business unit or client. Based on this understanding, provides input into the audit and closed file review planning process.

Coordinates and schedules individual audits or closed file reviews. Ensures leadership is effectively notified of timing, scope and nature of audit. Secures appropriate resources to deliver effective and efficient audit.

Uses all tools available to drive highest value audit and closed file reviews (designing tests of control and effectiveness, as well as tests of details). Is proficient in audit sampling techniques.

Oversees accomplishment of tasks required to complete audits and closed file reviews. Matches the difficulty of tasks with the appropriate skill sets. Plays an active hands-on role in the audit.

Supervises staff auditors. Assigns and reviews audit work products. Motivates staff to perform at high level of effectiveness and efficiency.

Ensures audit procedures performed are adequately documented to support conclusions and work papers are properly maintained in accordance with record retention policy.

Summarizes audit findings and conclusions in an audit or closed file review report. Obtains management agreement regarding action steps and recommendations. Ensures action plans and recommendations address the root cause of identified problems, have reasonable time frames and are properly researched and documented.

Completes meaningful post-audit performance evaluations of auditors.

As requested, drafts and summarizes year-end audit summaries.

Completes special projects and reviews as needed.

As requested, collaborates with leadership to ensure that necessary training is developed and implemented in response to trends identified by the quality assurance process.

Provides input to the Subrogation Supervisors as they develop their specialists performance reviews.

Ensures and measures calibration skills among quality assurance personnel.

Responsible for the management of associates including performance management, training and development, workflow planning, hiring and placement, and disciplinary actions.

Determines and resolves workload and assignments of Quality Assurance team to ensure effective and efficient auditing and time management.

Develops and maintains positive working relationships with leadership team in support of seamless integration of recovery pursuits with claims handling while effectively appling Best Claims and Recovery Practices.

Other duties as assigned.

JOB REQUIREMENTS:

Education: Undergraduate degree or equivalent experience.

Experience: Eight to ten years of progressive experience in personal lines or commercial lines property, casualty and/or material damage claims required.  Multi-line claims exposure and multi-jurisdictional experience preferred. Claims management/supervisory experience preferred. Claims consulting experience preferred. 

Knowledge: Requires advanced knowledge of claims best practices, technical claims operations, procedures and claims performance strategies, day-to-day claims operations, as well as Claims Best Practices.  Requires advanced knowledge of claims operating practices, and claims litigation laws and regulations. Knowledge of Recovery practices and procedures including planning and administration, business operations, claims handling, and claims payment operations. Management techniques including associate administration, team building and training, Best Claims and Recovery Practices. 

Skills/Competencies:  Proven presentation skills and demonstrated ability to analyze and evaluate data relative to claims technical performance reviews.  Ability to assess and make determinations regarding problematic areas and advise leadership of action plans. Proven ability to make independent decisions regarding claims file performance. Demonstrated problem solving skills including the ability to diagnose and recommend solutions. Demonstrates strong but flexible standards and can be perceived as balanced based on the conflicting demands of the position. Ability to be flexible and handle multiple projects. Excellent oral and written communication skills used to interact with all levels of associates and excellent conflict management skills. Comfort level around senior management to make appropriate recommendations. Strong organization and planning skills to set priorities, and to plan work. Ability to formulate business questions/problems into analytical questions, and conduct analyses. Ability to effectively operate personal computer and multiple database and business software.

JOB CONDITIONS:

Working Conditions: Normal office environment or remote office environment.  May require ability to sit and operate telephone and personal computer for extended periods of time.  Ability to travel up to 20% required. 

ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.